New Method Can Predict Whether Tylenol-Poisoning Patients Need Liver Transplant

News-Medical (02/27/12)
A study on acetaminophen from University of Utah mathematicians is scheduled to be published in the journal Hepatology. The researchers found that by using a set of eight main 'differential equations' with data from four common medical lab tests - AST, ALT, INR, and creatinine - they can quickly and accurately predict which patients with an overdose of acetaminophen can survive with only medical treatment and which will need a liver transplant to keep them from dying. The measured levels of AST, ALT, and INR allow for the estimation of when and how much acetaminophen was taken, and that information, when combined with the creatinine levels allows for the predictions to be made. The research, which retrospectively analyzed the records of 53 acetaminophen overdose patients, had been funded by a National Science Foundation grant to the University's mathematical biology program. The researchers tested the equations by using the information from the lab tests in the records then comparing the equations' predictions to the outcomes of each record. Two patients were excluded as they received transplants and the researchers were unable to know if they would have survived without that treatment. The equation method was relatively accurate, predicting with 100 percent accuracy the deaths of the eight patients who died, as well as the survival of 30 patients who survived. There was a 61 percent accuracy in overall prediction of who would die, as the equations predicted that outcome for 12 patients, but only eight died; and a 91 percent accuracy as it predicted that 39 patients would survive, while 43 did. The researchers noted that there were many reasons behind the deaths, including late arrival for treatment and not qualifying for a transplant. The study advocates for another clinical trial, and a one-year prospective trial is planned for the University of Utah and three Houston hospitals. The study coauthor notes that the method needs some refinement to take into account special cases, such as patients on other drugs, or who suffer from chronic alcohol abuse or anorexia.

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